Use of a Structural Deformity Index as a Predictor of Severity among Trauma Victims in Motor Vehicle Crashes

Abstract

Background: Information obtained from vehicle crash scenes, called kinematics, may prove useful in the management of victims and may complement anatomical and physiological findings. Objectives: In addition to analyzing the significance of age, gender, position occupied in the vehicle, the use of restraint systems, and ejection from the vehicle, the objective was to carry out a preliminary study of what we have defined as the Structural Deformity Index (SDI) to verify its usefulness in predicting injury severity at the scene of a motor vehicle crash. The index consists of various parameters that can be easily identified at the crash scene. Method: An historical cohort of vehicle occupants involved in crashes in the Navarra province of Spain from January 1, 2001 to December 31, 2002 was studied. Information was collected from the database of the Navarra Severe Trauma Victim group study. Bivariate statistical analysis and multivariate logistic regression models were employed for statistical management. Results: There were 212 vehicle occupants identified. Significant differences in severity of injury, and of mortality, were observed based on age, ejection from the vehicle, and a high SDI. Logistic regression showed significant differences in injury severity by age (odds ratio [OR] 6.55, 95% confidence interval [CI] 1.6–26.7) and high SDI (OR 1.84, 95% CI 1–3.3), as well as differences in the patient death rate by age (OR 6.92, 95% CI 1.2–38.9) and high SDI (OR 3.28, 95% CI 1.5–6.8). Conclusions: The SDI is useful to the first responders, enabling them to alert and transmit objective, reliable information to the emergency coordination center, thus efficiently activating health care resources. In addition, use of the SDI may assist prehospital and hospital health care providers to suspect the presence of particular serious injuries when anatomical and physiological criteria are not definitive.

Keywords: vehicle occupants, vehicle crash, severity of injury, seat belt, occupant position, ejection from vehicle, structural deformity, kinematics, Structural Deformity Index (SDI)